慢性乙型肝炎患者外周血纤维化蛋白表达水平与肝纤维化的相关性分析  

The correlational study of the relationship between the fibrosin expression in peripheral blood and hepatic fibrosis

作　　者：李曼[1] 曾震军[1] 孙学华[1] 朱晓骏[1] 周振华[1] 高月求[1] 

机构地区：[1]上海中医药大学附属曙光医院肝病科细胞免疫实验室,上海201203

出　　处：《临床肝胆病杂志》2011年第12期1312-1315,1317,共5页Journal of Clinical Hepatology

基　　金：国家自然科学基金(81072792);上海高校创新团队建设项目(第一期);"十一五"国家科技重大专项(2008ZX10005-006);上海市教育委员会重点学科(第5期)(J50307);上海市科委优秀学科带头人(10XD1404100);上海中医药大学优秀团队培养计划;上海市教育委员会E研究院建设计划项目(03008);上海市教委预算内科研项目(2010JW43);国家中医药管理局中医肝胆病重点学科(2010sh)

摘　　要：目的研究慢性乙型肝炎患者外周血纤维化蛋白(FBRS)的表达水平与肝纤维化的相关性。方法收集52例慢性乙型肝炎患者,全部进行肝脏穿刺活检,将肝穿刺标本肝组织胶原纤维采用Masson三重染色和常规病理HE染色,判定肝脏纤维化分期和炎症活动度分级;检测患者外周血的ALT、AST、TBil、白蛋白(Alb)、HBV DNA载量;分离患者外周血单个核细胞,提取RNA,Real-time PCR法检测FBRS的表达水平;分析FBRS表达水平与肝组织病理分级和炎症活动度等指标的相关性。结果按照肝组织纤维化程度(S)分组,外周血单个核细胞FBRS mRNA水平从S0至S4随着肝纤维化程度的加重表达水平增加,且均比前一期明显升高(P<0.01),S与FBRS mRNA水平呈正相关(P<0.05);按照肝脏炎症活动度(G)分组,随着炎症活动度的加重,FBRS mRNA表达水平有增高的趋势,G与FBRS mRNA水平呈正相关(P<0.05),G2与G1比较差异有明显的统计学意义(P<0.01),G3与G2,G4与G3比较,虽然有升高的趋势,但差异无统计学意义(P>0.05);ALT与FBRS mRNA表达水平呈正相关,Alb与FBRS mR-NA表达水平呈负相关(P<0.05)。结论慢性乙型肝炎外周血FBRS的表达水平与肝组织纤维化程度呈正相关。Objective To investigate the relationship between the expression of fibrosin（FBRS） and hepatic fibrosis. Methods 52 chronic hepatitis B patients were collected. Liver puncture samples were stained with HE and Masson trichrome stain. Hepatic fibrosis stage and hepatic inflammation grade were analyzed according to the standard of prevention and treatment scheme of viral hepatitis. Serum biochemical tests in- cluding ALT, AST, TBil, Alb and HBV DNA load were examined. FBRS mRNA expression level in peripheral blood mononuclear cells were examined by Real - time PCR. The relationships among hepatitis pathological grade, serum biochemical index, HB~ DNA load and fibrosin ex- pression level were analyzed. Results FBRS mRNA expression level was gradually increased in patients from SO to S4, and FBRS mRNA level in the later stage was significantly higher than that in the former （ P 〈 0.01 ）. A positive correlation was shown between FBRS mRNA expression level and hepatic fibrosis stage. FBRS mRNA level in G2 grade was significantly higher than that in G1 grade （P 〈0.01 ）, and FBRS mR- NA level was increased gradually with the development of hepatic inflammation grade, but there were no significant differences between G3 and G2 ,G4 and G3 （P 〉 0.05 ）. FBRS mRNA level was positively correlated with the serum level of ALT, and FBRS mRNA level was negatively correlated with the serum level of Alb. Conclusion FBRS mRNA level was closely related with the degree of hepatic fibrosis.

关 键 词：肝炎 乙型 慢性 肝硬化 纤维化蛋白 

分 类 号：R575.2[医药卫生—消化系统]